One of the most common problems of the skin seen in old age is
dry, cracked, fissured skin which is itchy in nature. Almost everyday
I get a patient with dry, cracked, heels and shins especially during
winter months.

WHAT IS ASTEATOTIC ECZEMA?

Though this name may sound very unfamiliar the skin problem is
not. It was first described by a scientist in 1907 and he called
it ECZEMA CRAQUELE because of the characteristic fine cracks which
developed in the skin due to this problem. Another scientist described
the skin as having a cracked porcelain appearance.
Asteatotic eczema is nothing but a form of eczema in which the skin
becomes dry, cracked, pruritic and fissured. It is most seen on the
shins and legs of elderly people but can also occur on the skin of
the hands and trunk.

WHAT ARE THE FACTORS THAT CAUSE ASTEATOTIC ECZEMA?

The factors that affect this problem are:
1. Old age
2. History of Atopic eczema
3. Dry climate with low humidity. Cold winds can also increase loss
of water from the skin.
4. Overexposure to water or working in water
5. Using harsh detergents or soaps
6. Malnutrition
7. People with Thyroid disorder
8. Neurologic disorders, which decrease the sweating in the affected
area
9. Bathing frequently with Hot water and use of harsh soaps.
10. Radiation
11. Nutritional deficiencies like zinc and malabsorption of essential
fatty acids.
12. Poor dietary habits.

HOW DOES ASTEATOTIC ECZEMA OCCUR?

Due to some reason, whether aging, dry weather or malnutrition,
when the surface layer of the skin loses water the cells shrink.
These shrinking cells create stress on the skin's elasticity causing
fissures or tiny cracks to form. When this problem increases the
cracks deepen till they can even cause breakage of tiny blood vessels
causing swelling and bleeding.
Elderly people tend to lose more water from their skin as they have
fewer sweat and sebaceous glands left. Also those people on antiandrogen
therapy or diuretic drugs seem to be more prone to this problem due
to excess loss of water. For some reason elderly men tend to suffer
from this skin problem more than women.

WHAT ARE THE SIGNS AND SYMPTOMS OF ASTEATOTIC ECZEMA?

1.The first signs seen of this skin problem are tiny fine fissures
seen in the upper skin layer. These fissures may then increase in
size and become deeper.

2. There may be scaling of the skin in the affected parts. The
most common parts affected are the front of the leg or shinbone area.

3. The skin may appear red due to the repeated scratching.

4. The patient will complain of an itching sensation in the affected
area.

5. There might be bleeding due to the deep cracks, which have formed.

6. The affected area or leg may have a swollen appearance.

7. There may be secondary infection or dermatitis. There may be
oozing and crusting on the affected parts.

WHAT CARE CAN BE TAKEN IN ORDER TO PREVENT THIS SKIN PROBLEM?

There are number of things that you can be careful of in order
to prevent Asteatotic eczema from occurring.

1. Drink plenty of water throughout the day. This is very important
for the skin cells to retain their shape and volume.

2. Avoid bathing more than once a day and with very hot water.
Every time you bath you are losing natural layer of oil from your
skin, which helps to retain moisture in the cells.

3. Be careful while selecting your daily soap. It is best to avoid
using soap in areas where not required.

4. Do not use or put your hands in detergent. You can use gloves
if using detergent for your work is necessary.

6. Use a good moisturizer immediately after your bath in order
to replace the lost layer of natural oil. If your skin is dry use
this more than once a day. Petroleum jelly is one of the most effective
emollients, which should be used in case of dry skin.

7. Elderly people should take care of their skin especially since
they may be on drugs like diuretics which dehydrate the skin and
make your lose water.

WHAT IS THE TREATMENT FOR ASTEATOTIC ECZEMA?

Most allopathic physicians and skin specialists will prescribe
steroids for this condition due to the itching and discomfort. Though
effective this is only a temporary solution as it does not cure the
problem and has its own side-effects.

The way to cure this problem is to first educate the patient on
his problem, dietary changes, lifestyle changes like what soap he
is using and how many times does he bathe. Also check his medication
and see if that is causing him problems. Advise him on the use of
emollients or moisturizers and then give him the correct Homoeopathic
remedy to cure the problem.

PETROLEUM

This is a wonderful remedy for dry skin especially in the winter
months.
Chapped hands and fingers, cracks on the skin call for Petroleum.
The patient says that he feels much better in summer and has no dryness
but come winter his skin problems surface.
The skin of a Petroleum patient feels dry, parched, constricted,
as if the skin is dehydrated. There is redness, "itching", and bleeding
from the cracks. Here thick, greenish crusts are formed. Even wearing
clothes becomes a problem and is painful for the person suffering.

Petroleum 30, 5 pills four times a day will bring great relief.

XEROPHYLLUM

As the name only suggests this is a very useful drug for treating
dry skin disorders and Asteatotic eczema. Here the patient will describe
his symptoms saying that he feels as if the skin is like leather.
It is rough and cracked. There may be inflammation of the skin and
redness.
The patient will also complaint of intense itching and burning of
the skin. He feels as if something is stinging.
However he feels worse with cold application and better if something
warm is applied to the skin to which will reduce the itching and
stinging.

A 60 year old male came to my clinic with the problem of dry skin.
He had been suffering with this problem since many years and no matter
how many different creams and ointments he had applied the skin would
not get better. His skin appeared very dry and rough in nature especially
on the front of his legs.
There were small whitish scales over his skin, which would flake
off and then re-appear. The itching was so intense that it was driving
him crazy. It was especially bad when he undressed and also after
bathing. Peculiarly the only thing that made him feel better was
heat.
On asking about his past illness he mentioned that he had suffered
from tuberculosis as a child and had been treated for it.

Tuberculinum 1M, 5 pills in constitutional doses were given to
him, which not only helped the skin tremendously but also gave him
a sense of wellbeing.

SULPHUR

This is one of the most useful remedies in treating cases of skin
problems in Homoeopathy where the symptoms are present. Here the
skin appears dry, scaly, unhealthy. The itching is worse after a
bath or washing the affected area. It is also worse at night and
sensitive to cold air.
Due to the constant irritation there may be discharge of pus from
the affected area and this may even lead to ulceration. The itching
sensation troubles the patient and makes him very restless.

Suphur 200, should be given in constitutional doses when the symptoms
are present.

This article is written in order to make people aware of what Asteatotic
eczema is and how you can help yourself. However self medication
is not advise especially in the elderly.

Readers are advised that the medical
advice offered in this column pertains to generalised treatment
of condition. Kindly consult your doctor before self-medication.